1. Scalable Intervention Technology
for Older Adults in the Home
Holly Jimison, PhD
Department of Medical Informatics, OHSU
Funding: National Science Foundation, National Institute on Aging,
Alzheimer’s Association, and the Intel Corporation

2. Scalable Approach to Delivering
Interventions to the Home
 Remote, just-in-time, continuous care
 Incorporate principles of health behavior
change
 Optimal use of lower cost personnel
 Integrate family & informal caregivers into the
health care team (untapped resource)
 Platform for testing sustained interventions in
the home

3. Home Monitoring Data

4. Platform to Deliver a Scalable
Coaching Intervention to the Home
 System to facilitate a single coach in
managing a large number of clients
 Semi-automated tailored messaging based on
home monitoring and self-report data
 User assessment  user model  tailored
data sharing, action plan, coaching messages
 Multiple modules – not single condition or
approach

5. Modular Software for Multiple Protocols
 Cognitive Exercise (computer game format)
 Novelty exercise
 Physical Exercise
 Sleep Management
 Socialization
 Medication Management
 Mood Management

6. Participant Home Page
Participant home page
• Messages from coach
• Featured story
• Weekly goals
– Activities
– Surveys
• Access modules
– Physical Activity
– Sleep
– Socialization
– Novelty Mental Exercises
– Cognitive Games
• Coaching Process
• Participant Materials
6

7. Coach Messaging
• Messages from Coach • Messages to Coach
7

8. Physical Activity Module
8

9. Physical Activity Module-continued
9

10. Sleep Module
10

11. Socialization Module
11

12. Socialization Protocols for Cognitive Health
 Web cams and Skype software given to
participants and their remote family partner
 Frequent spontaneous use among participants

13. Cognitive Computer Games
- embedded monitoring algorithms

14. Health Coaching Platform Architecture

15. Health Coaching Platform Architecture
Family Interface
• Safety monitoring
• Soft alerts
•Team-based care
• Socialization

16. In-Home Cognitive Health Coaching Studies
 Needs Assessment
 Coach Messaging Study
 Ongoing Usability Testing
 Feedback on Cognitive Games and Novelty Exercise
 Current Coaching Study
 20 participants in the ORCATECH Living Lab
 20 additional participants from larger monitoring study
 Average age 78.3 ± 7.8 years
 70% female
ORCATECH 16

17. Lessons Learned: Important Software Issues
 User centered design – ease of use
 Inference algorithms for assessing patient state and
context
 Sophisticated User Models
 Privacy / Security – tailored privacy models for
the sharing of home monitoring data
 User models for tailoring interventions and
coaching messages
• Intelligent Interoperability

18. Summary:
Benefits of Technology for Remote Coaching
 Scalable approach to delivering interventions to the
home
 Extends the reach of lower cost professionals
 Community-based culturally-specific coach
 Timely and continuous
 Aim to keep people independent ( QoL &  costs)
 Integrates untapped resource of family and informal
caregivers into the care team
 Tailors interventions to individuals
 Integrates health and wellness interventions